Term
| What are the cell characteristics on the malignant neoplasms? |
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Definition
| Cells are undifferentiated with anaplasia and atypical structure that often bear little resemblance to cells in the tissue of origin. |
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Term
| What is the mode of growth for cancer cells? |
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Definition
| Growth via invasion - infiltrate surounding tissue |
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Term
| What is the rate of growth of cancer cells? |
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Definition
| Variable and depends on level of differentiation; the more undifferentiated the cells, the more rapid the growth. |
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Term
| What is the metastasis of cancer cells? |
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Definition
| Gains access to the blodo and lymph channels to metastasize to other areas of the body. |
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Term
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Definition
| Exists in all mammalian systems, responsible for vital cellular fxns of growth and differentiation. |
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Term
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Definition
The process by which cancer arises.
-Initiation
-Promotion
-Progression
-Metastsis |
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Term
| What is lymphatic spread? |
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Definition
Transport of the tumor cells through the lymphatic circulation is the most common mechanism of metastasis.
Enter lymphatic system through interstitial fluids. Can either lodge in lymph nodes or circulate in venous system. |
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Term
| What is hematogenous spread? |
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Definition
Dissemination of the malignant cells in the blood stream.
Attach to vessel wall and attract platelets and fibrin to create a protective barrier around it. |
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Term
| What is the etiology of cancer? |
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Definition
Viruses and bacteria
Physical agents
Chemical agents
Genetics and familial factors
Dietary factors
Hormonal agents
Role of the immune system |
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Term
| What is the role of the immune system in cancer? |
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Definition
Immunocompromised people have a higher incidence of cancer (kaposi's sarcoma in AIDS)
Sometimes the immune system can detect these cancerous cells and kill them before they grow. |
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Term
| What are primary preventative measures for cancer? |
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Definition
| Educating the community about cancer risks and how to avoid them |
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Term
| What are secondary preventative measures for cancer? |
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Definition
| Focus on early detection and screening |
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Term
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Definition
Patient's suspected with cancer undergo
1.) determine the presence of tumor and its extent
2.) identify possible spread of disease or invasion to other tissues
3.) Evaluate the fxn of involved and uninvolved body systems and organs
4.) Obtain tissue and cells for analysis to assists in veal of type, stage and grade. |
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Term
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Definition
| Determines the size and the extent of disease. |
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Term
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Definition
STAGING
T - primary tumor
N - regional lymph nodes
M - distant metastisis |
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Term
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Definition
| The classification of tumor cells |
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Term
| What are the grades of tumors? |
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Definition
-GX - unable to assess
-G1 - well-differnetiated (resembles tissue of origin)
-G2 - Moderately differentiated
-G3 - Poorly differentiated (little resemblance to tissue)
-G4 - Undifferentiated (unable to tell tissue of origin) |
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Term
| What types of cancer surgery are there? |
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Definition
-Diagnostic surgery
-Surgery as primary treatment - local + wide excision
-Prophylactic - remove things just in case
-Palliative - improve complications of cancer |
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Term
| What are the ranges of treatment goals? |
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Definition
| diagnostic, curative, prophylactic, or palliative |
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Term
| What is radiation therapy? |
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Definition
| Ionizing raDIATION IS USED TO INTERRUPT CELLULAR GROWTH. |
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Term
| What are the safety measures of radiation therapy? |
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Definition
-Time, distance and shielding to HCP
-Priavte room
-Posting appropriate notices
-Dosimtere badges
-No preggers
-No kids
-Limits visits to 30 mins
-6 foot distance from person |
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Term
| What is the nursing care of someone undergoing radiation therapy? |
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Definition
-Providing education on safety precautions
-Protecting skin and oral mucosa
-nutritional status
-general feeling of well-being |
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Term
| How do you protect skin in radiation therapy? |
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Definition
-Avoid ionments, lotions or powers on treated area
-Gently cleanse area with fingertips and mild soap
-Do not remove markings on skin if DR put them there
-Can use aquaphor but not up to 4 hours before radiation
-Electric razor
-Avoid constrictive clothing
-Avoid sun |
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Term
| What is the oral care for radiation therapy? |
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Definition
-Bland mouth wash
-Gentle after meals and at bed time
-Fluoride preparations
-Leave dentures out
-Avoid alcohol, tobacco, etc.
-Avoid hot and cold drinks
-Insepect mouth daily
-Put on chapstick |
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Term
| What s/e do external radiation cause? |
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Definition
S - severe NV
H - hematuria
A - alopecia/anemia
D - diarrhea
E - evaluate skin for redness and dryness |
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Term
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Definition
| Antineoplastic agents are used in an attempt to destroy tumor cells by interfering with cellular functions including reproduction. |
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Term
| What are the classifications of chemotherapy agents? |
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Definition
-Cell cycle specific agents
-Cell cycle nonspecific agents |
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Term
| What is a cell cycle specific agent? |
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Definition
Certain chemotherapy agents that are specific to certain phases of the cell cycle. Most affect in the S phase that deals with DNA/RNA synthesis.
-Topoisomerae I inhibitors
-Antimetabolites
-Mitotic Spindle Poisons |
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Term
| What is a cell cycle nonspecific agent? |
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Definition
Act independently of the cell cycle. Prolonged effect and last longer causing cell death or damage.
-Alkylating agents
-Nitrosureas
-Antitumor Antibiotics
-Hormonal Agents |
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Term
| What technique is used for administering chemotherapy? |
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Definition
| The route of administration usually depends on the location of the cancer, the dosage needed, type of agent, the extent of the tumor |
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Term
| What do you do for hypersensitivity? |
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Definition
Hypersensitivity and extravasation
Hypersensitivity = rash, flushing, anxiety, bronchospasm, hemodyanmic collapse. IF THIS HAPPENS, STOP TRANSFUSION IMMEDIATELY. Give antihistamines, epi, and steroids. Can resume once symptoms correct usually. |
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Term
| What do you do for extravasation? |
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Definition
| Extravasation = Chemotherapy drugs leaking from IV site into surrounding tissues. SIGNS - Absence of blood return, resistance to flow, swelling/pain/reddness at the site. If you have a central line - pain in the upper arm, upper back, neck, jaw, chest. STOP MED IMMEDIATELY, ASPIRATE DRUG FROM LINE, ADMINISTER ANTEDOTE IF AVAILABLE, APPLY ICE TO SITE, AVOID FURTHER TRAUMA TO SITE. |
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Term
| What is Hematopoietic Stem Cell Transplantation (HSCT)? |
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Definition
| A method that uses apheresis to collect donor peripheral blood stem cells for rein fusion. Do not have to harvest marrow to promote cell growth. |
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Term
| What do nurses do who are administering chemotherapy? |
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Definition
-Use biologic safety cabinet for demo
-Wear gloves that have been test with chemotherapy agents
-Wear disposable, nonabsorbent long sleeved gowns
-Use Luer-Lok fittings on all IV tubing
-Dispose of all equipment used in chemotherapy preparation and administration in appropriate, leak proof containers.
-Dispose of all chemo wastes as biohazard |
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Term
| What are the types of HSCT? |
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Definition
-Autolougous (from pt)
-Allogenic (from a donor other than the pt; either related, or matched unrelated)
-Syngeneic (from identical twin) |
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Term
| What are the potential complications of allogenic HSCT? |
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Definition
High risk for infection, sepsis, and bleeding.
Acute = alopecia, hemorrhagic cystitis, n/v/d, stomatitis
Chronic = sterility, pulmonary dysfxn, cardiac dysfxn, liver dz. |
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Term
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Definition
Graft-verus host disease
T lymphocytes that came from the donor marrow become activated and mount an immune response against the pt's tissues.
Can occur within the first 100 days (acute) or after (chronic) |
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Term
| What are the major goals for the patient you are taking care of with cancer? |
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Definition
| management of stomatitis, maintenance of tissue integrity, maintenance of nutrition, relief of pain, relief of fatigue, improved body image, effective progression through the grieving process, and absence of complications |
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Term
| What are the NIC for the pt with cancer? |
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Definition
Managing fatigue
Monitoring for infection and preventing infection
Neutropenia
Monitoring for bleeding and preventing bleeding
Managing stomatitis
Preventing and managing nausea and vomiting
Maintaining skin integrity
Promoting nutrition
Managing pain |
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Term
| Do patient's with cancer have to stay in the hospital |
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Definition
NO!
Many patients with cancer return home from acute care facilities to receive treatment in the home or outpatient area rather than acute care facilities
Referral for home care is often indicated |
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Term
| What is required for a pt to receive home care? |
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Definition
| assess the patient’s and family’s understanding of the treatment plan and management strategies and to reinforce previous teaching |
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Term
A public health nurse is presenting a health promotion class to a group of middle-aged adults. Which of these topics addresses the leading cause of cancer deaths in North America?
Technique for self-breast examination
Strategies for smoking cessation
Teaching about the importance of annual colonoscopies
Teaching about monthly testicular exams |
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Definition
B. Strategies for smoking cessation
Rationale: Despite changes in smoking rates, smoking contributes to many new cases of cancer each year. The health risks of smoking exceed the risks of foregoing screening procedures. |
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Term
A patient with cancer complains of fatigue and weakness after his first round of radiation therapy. How should the nurse best reassure this patient?
"These symptoms usually result from radiation therapy; we will continue to monitor your health closely."
"These symptoms are part of your disease and are inevitable."
"Don't worry about these symptoms. Everyone feels like this after radiation therapy."
"This is a positive sign because it means that the cancer is losing." |
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Definition
A. "These symptoms usually result from radiation therapy; we will continue to monitor your health closely."
Rationale: Fatigue and weakness result from radiation treatment and do not necessarily represent deterioration or disease progression. Radiation destroys both cancerous and normal cells. The symptoms obviously concern the patient and shouldn't be casually dismissed |
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Term
What should the nurse do to combat the most common adverse effects of chemotherapy?
Administer an antiemetic
Administer an antimetabolite
Administer a tumor antibiotic
Administer an anticoagulant |
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Definition
A. Administer an antiemetic
Rationale: Nausea and vomiting are common and debilitating adverse effects of many types of chemotherapy. As such, aggressive and proactive antiemetic administration is often necessary. |
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Term
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Definition
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Term
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Definition
| Does it look like the tissue of origin? |
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Term
| Do you raise head of the bead with cervical cancer? |
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Definition
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Term
|
Definition
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Term
| Does chemo cause neuropathy? |
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Definition
Yes, can be a side effect of chemo.
HAIR, GI, and BONE MARROW USUALLY AFFECTED |
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Term
| What is considered a fever with a reaction to HSCT? |
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Definition
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Term
| What should be avoided for stomatitis? |
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Definition
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Term
| If going home on oral chemo, what teaching? |
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Definition
-SAME TIME EVERY DAY
-COME IN FOR BLOOD TESTS REGULARLY
-S/S OF BLEEDING AND INFECTION |
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Term
The nurse is caring for a patient with implanted radioactive for uterine cancer. Which of the following precautions should the nurse observe? (Select all that apply)
A.) Limit patient contact to 45 minutes for 12 hour shift
B.) Maintain HOB in high fowlers
C.) Maintain distance 3 ft from patient
D.) Maintain bed rest
E.) Pregnant nurses should not take care of this patient |
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Definition
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